OBJECTIVE To measure the effect of routine perioperative lumbar drain placement during anterior skull base surgery on the frequency of: 1) tension pneumocephalus and 2) total intracranial complications. DESIGN Retrospective review of a series of patients (n = 161) who underwent the transglabellar/subcranial approach to lesions of the anterior skull base between December 1995 and November 2009...

A six-year-old female was evaluated at the Emergency Department after being struck by an automobile driving 15-20 mph through a pedestrian crosswalk. The initial assessment was significant for a blood pressure at 104/72 mm Hg, heart rate at 124 beats per minute, decreased breath sounds in the left chest with agonal respirations, bleeding from right ear and back of head, open eyes, and non-verba...

A 41 years old male, known case of valvular heart disease on anticoagulants was operated for chronic subdural hematoma 4 days back at another facility (Fig. 1). Despite hematoma evacuation patient did not show the expected neurological recovery, rather his clinical condition had deterioration. At the time of admission patient was drowsy with Glasgow coma score of E2V2M3 and had pupillary asymme...

Epidural steroid injection is a common treatment for the management of pain in a wide variety of patients. It is generally well tolerated and perceived to have few side effects, with a low risk of serious complications. Only a handful of reports exist that describe life-threatening complications such as subdural hematoma, respiratory depression, vasovagal response, and pneumocephalus. This is a...

Pneumocephalus is a rare but important complication of acute isolated sphenoid sinusitis (ISS). If not adequately treated, it may cause serious neurological and life-threatening complications. We report the presence of free air in the cavernous sinus arising from intracranial extension of acute ISS. A 41-year-old healthy man presented to our department with a 7-day history of headache. Neurolog...

Sir, We report an unusual case of congenital hydrocephalus that developed acute tension pneumocephalus six months after the ventriculo-peritoneal shunt surgery. Delayed and symptomatic pneumocephalus following shunt placement is rare and has been described in only 11 cases so far. A 19-year-old female had undergone ventriculo-peritoneal shunt surgery for obstructive hydrocephalus secondary to c...

The article by Jarjour and Wilson (Chest 1989; 96:1425-26) on pneumocephalus associated with nasal continuous positive pressure ventilation in a patient with sleep apnea syndrome was of particular interest to us. Recentk@ we noted the development of pnetimoce phalus in a patient admitted to the pulmonary/ICU service who had undergone multiple lumbar puncture attempts. A literature search reveal...